1. Field of the Invention
The present invention relates to a suture securement apparatus. In more particular, the present relates to a suture securement apparatus which is utilized in connection with a threading assembly to provide desired securement of percutaneous catheter puncture wounds and/or drainage catheter apparatus.
2. Relevant Technology
One of the challenges that is often encountered in the use of percutaneous catheter insertion relates to the maintaining of the catheter within the catheter insertion site and also the proper maintenance of homeostasis subsequent to removal of the catheter from the catheter insertion site. A variety of different suturing techniques have been utilized in connection with percutaneous catheter puncture wounds and the maintenance of catheters within the percutaneous catheter insertion sites. However, inadvertent slipping or removal of catheters and desired closure of percutaneous catheter puncture wounds subsequent to removal of such catheters has resulted in undesirable patient discomfort and at times a partial or total loss of homeostasis.
One of the techniques that is often utilized with percutaneous catheter puncture wounds is the use of a purse string suture. A purse string suture is formed by inserting a suture, such as a monofilament or braided thread into the patient's skin at a position adjacent the puncture site. The practitioner then forms a circular series of continuous stitches which parallel the edges of the wound in a substantially circular pattern. The configuration of the stitches results in a plurality of segments of suture which alternate between being threaded under a portion of the patient's skin and being position over the surface of the patient's skin. Typically, the resulting suture configuration has between three and four segments of stitches which are positioned above the skin around the edges of the wound. A tail of the suture extends from both the pre-insertion site and also at the emergent site such that the purse string suture appears to have two tails which emerge somewhat close in proximity to one another at a predetermined point around the edge of the puncture wound.
The purse string sutures allow a practitioner to close the wound by simply pulling on the two ends of the suture thus tightening the suture which is then threaded around the perimeter of the wound site. Pulling the tails of the purse string sutures effectively closes the wound site and results in the desired homeostasis. In this manner, excessive compression or other techniques which are typically utilized to stop puncture wound bleeding are not needed.
One of the challenges which has been experienced with purse string suture closure methods and the desired maintaining of homeostasis utilizing the purse string suture relates to the knotting or other techniques for maintaining tension on the adjacent ends of the purse string suture. One mechanism which has been utilized employs a knot at one end of one suture which engages the other suture to maintain the desired tension of the overall length of the purse string suture. However, the knot utilized in connection with such techniques can compromise the integrity of the purse string suture. Additionally, the knot can make subsequent loosening and retightening of the purse string suture difficult if not impossible. Additionally, non-doctor practitioners may be unwilling or uncomfortable with removing such sutures at the end of the procedure. As a result, the doctor must see the patient to remove the suture, or the patient may be required to come in for an office visit that may be inconvenient or otherwise impractical.
Another technique which has been utilized is to attempt to utilize a secondary securement apparatus to secure the ends of the suture. However, such techniques often result in excessive tension on the purse string suture which can cause puckering or unnatural distortion of the patient's skin adjacent the purse string suture site. As a result, unnecessary discomfort and/or damage to the patient tissue can result.